? 11/19 scratches amps 250, +2 438

[Scratches123]

I'm having a real hard time with scratches today. For the last few weeks, she's been consistently having high numbers around 300, she will dip after her shots sometimes by six hours in the 150s or less so I know the insulin is working it's just not the correct dose yet. She's on one unit of insulin. I'm raising her unit tonight to 1.25, I was planning on raising it last night but out of habit I gave her one unit and did the same thing this am because I'm an idiot. I have a reminder on my phone to raise to 1.25 tonight....long story short. She was at 123 last night +6 and pre shot this am was around 250. +2 she was at 438. She's almost at 450 all day today and idk why. I called her vet and she said to raise her dose to 1.5 units (I'm prob not doing that bc on here you said raiseto raise by .25 at a time). So basically I didn't like her advice so I called her other vet. The technician told me to give her one unit right now, and to call them at five pm tonight to give what her sugar is(five hours after I give the one unit) and they'll tell me how much to raise her dose to tonight at her shot time. I really don't think that's right and I told her that she she said "oh it'll be fine". I'm thinking "three shots in one day, no way" I'm so friggen frustrated I could cry. I'm just going to raise her unit to 1.25 like everyone on the forum said to do and basically just forget her vets.

 

[Gill & George]

three shots in one day, no way" I

No do not give three shots in one day. Not something recommended with a depot insulin.

Those reds look like a bounce, basically she got to numbers that she is not used to and her body reacted, resulting in her liver dumping glucose into the blood stream.

As you have decided to follow SLGS, that 127 would see you continuing to hold the dose.

From the guidelines for SLGS
Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

I've got to dash out now, I'll pop back later to elaborate some more.

 

[Scratches123]

No do not give three shots in one day. Not something recommended with a depot insulin.

Those reds look like a bounce, basically she got to numbers that she is not used to and her body reacted, resulting in her liver dumping glucose into the blood stream.

As you have decided to follow SLGS, that 127 would see you continuing to hold the dose.

From the guidelines for SLGS
Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

I've got to dash out now, I'll pop back later to elaborate some more.

Okay so should I increase to 1.25 tonight or wait? She dipped low last night she never gets that low, but still wasn't super low. And her numbers are usually consistently high.

 

[Scratches123]

I should add I was just able to successfully wean her off the dry kibble a couple days ago. She was only getting ten pieces or so on top of her pate up until then. I figured it was safe enough now to take it away. Her vet started her on insulin before telling me the importance of diet change so I've had a hell of a time getting her off the dry food. So, I'm assuming that could be a reason she dipped so low last night? I'm also assuming even as little as ten pieces of kibble can affect glucose.

 

[Chris & China (GA)]

I'm assuming that could be a reason she dipped so low last night? I'm also assuming even as little as ten pieces of kibble can affect glucose.

Absolutely!! We've had cats here that just ate 3-4 pieces and would go up over 200 points.

should I increase to 1.25 tonight or wait?

There's room for an increase to 1.25 tonight. Another thing to consider...you are testing enough to do TR. Is there a specific reason you chose SLGS?

On TR you can adjust the dose as often as every 3 days instead of holding the dose for a week.

 

[Scratches123]

Absolutely!! We've had cats here that just ate 3-4 pieces and would go up over 200 points.



There's room for an increase to 1.25 tonight. Another thing to consider...you are testing enough to do TR. Is there a specific reason you chose SLGS?

On TR you can adjust the dose as often as every 3 days instead of holding the dose for a week.

The reason I chose slgs was because I work a lot and it seemed like it wouldn't fit in with my schedule as I already had to change everything in my life. But, a couple others have brought it up to me recently that I could be doing TR. I have just been doing my research on it over the last couple days and reading and rereading so I know exactly what I'm doing with it before I start it. But yes, I am going to do the TR

 

[Sue and Luci]

She was only getting ten pieces or so on top of her pate up until then.

Please be extra vigilant now that she's off all the kibble. I call it 'Kitty Krack' because it's so loaded with carbs.

Glad to hear you're going to do TR. She looks like she's bouncing today - with those high numbers - but she'll be back down soon. Great job you're doing with the testing. I agree with above posters and you - only a .25 increase tonight please. You don't need to call your vet for advice on insulin - unless you just want to chat with them.

 

[Gill & George]

Given that she is of the kibble now completely, swapping to TR is a good idea (you were stuck with SLGS while kibble was in the picture). Good job I know how difficult it can be to get rid of the kibble for some cats.
You may want to put TR in the signature block, and also mark on the SS that you have swapped protocols (otherwise we will keep asking why did you hold the dose so long??)

She probably does need more insulin, but I might give her a couple more cycles before taking her up given that you have recently removed the kibble, it can take some kitties a little while for it to work out of their system. Could you make a note on the SS so everyone can see when you stopped the kibble completely.
I am nervous that her insulin needs will drop and you have a busy schedule.

I have a suspicion, given the way she has bounced into red, that she may have gone a lower than that 124 that you caught last night and then shot up by amps. I'd like to see what she does before taking her up.

How's your schedule in the coming days? Do you have a day off midweek? or are weekends best for a little extra monitoring if needed.

 

[Scratches123]

Given that she is of the kibble now completely, swapping to TR is a good idea (you were stuck with SLGS while kibble was in the picture). Good job I know how difficult it can be to get rid of the kibble for some cats.
You may want to put TR in the signature block, and also mark on the SS that you have swapped protocols (otherwise we will keep asking why did you hold the dose so long??)

She probably does need more insulin, but I might give her a couple more cycles before taking her up given that you have recently removed the kibble, it can take some kitties a little while for it to work out of their system. Could you make a note on the SS so everyone can see when you stopped the kibble completely.
I am nervous that her insulin needs will drop and you have a busy schedule.

I have a suspicion, given the way she has bounced into red, that she may have gone a lower than that 124 that you caught last night and then shot up by amps. I'd like to see what she does before taking her up.

How's your schedule in the coming days? Do you have a day off midweek? or are weekends best for a little extra monitoring if needed.

Sundays and Wednesday are the only days I have free. Wednesday im usually shopping and catching up. Im also wondering if she went lower than I thought last night. I will keep the dose for a couple more cycles now that she's off the kibble. Also...tonight I just noticed her gabapentin she's been on smells sweet so I tasted it and it tastes like sugar. I might make the decision to get her off that as well. Idk what to do about that, I shouldn't be giving a diabetic syrup!

 

[Scratches123]

I can monitor a little more tomorrow, but idk how much that will help since she's just been taken off the kibble. I still will, though.

 

[Sue and Luci]

Why is she on Gabapentin? I took Luci off that pretty soon after - I agree, it's like syrup...I don't know why they want to prescribe something syrup based to a diabetic cat?

As for monitoring - many cats will drop drastically once kibble is removed from their diet. The insulin is supposed to push the BG readings down AND if you add to that the fact that she's not going to be getting anymore carbs from the kibble AND possibly if you stop the Gaba - there's a recipe for some potentially rapidly decreasing numbers. Best to keep a close eye on her for a while...just until she adjusts to all of these changes.

 

[Gill & George]

Isn't there s sugar free version?

 

[Sue and Luci]

I think the pills are SF....my vet offered me pills (non sugar) and I said that she might as well not bother - pilling Luci is like wrestling Satin himself...she just won't have it...however liquids (with the sugar)...I seem to do better with that - she didn't like it one bit but I was able to syringe the gaba into her mouth...but it seemed sweet/syrupy...I didn't give it to her for long...

If Scratches will take a pill there is a SF version I believe. Ask the vet.

 

[Scratches123]

Why is she on Gabapentin? I took Luci off that pretty soon after - I agree, it's like syrup...I don't know why they want to prescribe something syrup based to a diabetic cat?

As for monitoring - many cats will drop drastically once kibble is removed from their diet. The insulin is supposed to push the BG readings down AND if you add to that the fact that she's not going to be getting anymore carbs from the kibble AND possibly if you stop the Gaba - there's a recipe for some potentially rapidly decreasing numbers. Best to keep a close eye on her for a while...just until she adjusts to all of these changes.

She has neuropathy in her back legs so she's on gabapentin. I'm just trying to take away the factors that could be causing her high blood sugar bc I really can't seem to get it under control and I feel like I'm trying so hard for her. I won't raise her dose just yet. Should she be taken off the gabapentin? I can call the vet tmr to ask about pill version. Also, what is the vitamin everyone talks about on here for the neuropathy? I can also look into that. I'm just at a loss why she's barely responding to insulin and now that she's off the kibble I hope to get some better results. I wasn't even thinking the gabapentin could be a cause also bc I just trusted my vet to give the right medications for her being diabetic.

 

[Scratches123]

Why is she on Gabapentin? I took Luci off that pretty soon after - I agree, it's like syrup...I don't know why they want to prescribe something syrup based to a diabetic cat?

As for monitoring - many cats will drop drastically once kibble is removed from their diet. The insulin is supposed to push the BG readings down AND if you add to that the fact that she's not going to be getting anymore carbs from the kibble AND possibly if you stop the Gaba - there's a recipe for some potentially rapidly decreasing numbers. Best to keep a close eye on her for a while...just until she adjusts to all of these changes.

I really don't have to do all this at once, just tell me what you think is the right thing to do. I don't want to hurt her. But, she is definitely off the kibble! Finally!!

 

[Gill & George]

• Give her a couple more cycles and see if she comes down of those reds and where she lands when she does. See if she makes it back to green.
• Note on SS when you stopped all kibble(use the comments section)
• note on the ss what you are feeding and when (use the comments section)
• note when she gets medication and what it is (use the comments section)
• make a note that you are changing to TR on the SS and in your signature

It's vitamin B12 for the neuropathy, there are two versions one is best for neuropathy, I'll just need to double check that for you, don't want to give you the wrong info.

 

[Gill & George]

this is what @Marje and Gracie wrote in another post

It seems there is some confusion regarding B12 so I hope I can clarify a bit.

There are two basic forms:
Methylcobalamin: important in CKD (along with small amounts of multi B Complex) to minimize the drop into anemia which almost all CKD cats experience; important in diabetics to counteract neuropathy
Cyanocobalamin: important for intestinal absorption

Normally, methylcobalamin has been given orally for CKD and diabetic neuropathy although, as Lizzie indicated, an injecttable form is now available. Cyanocobalamin is given as an injectable primarily in cats with IBD or any intestinal absorption issue.


zobaline is the oral product a lot of folk use, there's a cat specific version that hasn't got sugar in it and you don't need a prescription for it, though I would inform your vet that he is taking the supplement.

The important thing to remember is that the other thing that will play an important part in his neuropathy healing is regulation, you are still at early stages of getting the feline diabetes under control, getting to grips with this illness is a marathon not a sprint, you are taking all the right steps to get you there, it takes time.